1.1 INTRODUCTION
Nursing has been called the oldest of the arts and the youngest of the profession. The word nurse evolved from the Latin word nutritious, which means nourishing. The roots of medicine and nursing are intertwining and found in mythology, ancient eastern and western cultures and religion. Nursing, besides being a honorable profession, is one of the oldest arts and an essential modern occupation. Nursing is one of the greatest of humanitarian services and all people whether ill or well, rich or poor, literate or illiterate, young or old, at work or at play, in or out of hospital, are in some way or other, directly or indirectly closely associated with it. Nursing has its own body of knowledge scientifically based and humanitarianism that promises expanded benefits to people and society. It assists the individual or family to achieve their potential for self-direction for health.
1.2 DEFINITION
Nursing is defined by various authors at various times. Hansderson says “nursing is primarily assisting the individuals (sick or well) in the performances of those activities, contributing or its recovery (or to a peaceful death) that he would perform unaided, if he had the necessary strength, will or knowledge.
The unique contribution of nursing is to help the individual to be independent or such assistance as soon as possible.
- The International Council of Nurses defines “Nursing is to assist the individual, sick or well in the performance of those activities contributing to health or to its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge”.
- Florence Nightingale: Nursing defined as the act of utilizing the environment of the patient to assist him in his recovery.
- Canadian Nurses Association-1987: Nursing practice as a dynamic, caring and helping relationship in which the nurse assists the client to achieve and obtain optimal health.
- American Nurses Association: Nursing practice as direct goal oriented and adaptable to service the needs of the individual, the family and community during health and illness.
1.3 HISTORICAL DEVELOPMENT OF NURSING IN INDIA
1905: | Association of Nursing Superintendents was constituted/formed. |
1908: | Trained Nurses Association of India was established/formed. |
1909: | Bombay Presidency Nursing Association was formed. Missionary Nurses North India Board, set up under Medical Missionary Association of India. |
1911: | The South Indian Board was established Indian Nursing Association of Illinois (INAI) affiliated to International Council of Nurses. |
1912: | The First Nurses, Registration Act was enacted in Madras Presidency. |
1930: | The Christian Nurses Auxiliary formed by the missionary nurses. |
1934: | The Bengal Nurses Act was enacted for the nurses, midwives and Health vistor (HV) of undivided Bengal. |
1936: | The Mid India Board of Education affiliated to Christian Nurses league, Christian Nurses Auxiliary Association was affiliated to Trained Nurse Association of India (TNAI). |
1941: | Standardized pay scales and terms of services were established in Madras. State nursing superintendent, appointed at state level (Madras). |
1942: | The Auxiliary Nursing Service (ANS) was established. One nursing superintendent was appointed as nursing advisor at Directorate General of Health Services (DGHS), Government of India, to organize nursing services. |
1943: | Establishment of School of Nursing Administration for Military Nursing Services Health Survey and Development Committees (Bhore) constituted by Government of India. Study groups worked on proposal for university education in nursing in India. Christian Medical College (CMC) Vellore and Madras General Hospital started courses to train nursing tutors. Commissioned rank was given to the Indian Military Nursing sisters. |
1946: | Bhore Committee submitted report, recommendations made on improvement of various aspects of nursing profession: Nursing education, working conditions, nursing services in hospital and community and deputing nurses for higher education to abroad, etc. Establishment of the College of Nursing at Delhi (now Rajkumari Amrit Kaur College of Nursing) under the Union Ministry of Health to start university nursing education programme for the first time in India leading to Bachelor's degree in nursing, i.e., BSc (Hons.) Nursing. |
1947: | Indian Nursing Council Act was passed (31.12.1947) on the basis of recommendations of Bhore Committee. Degree programme for nursing started in Vellore. |
1948: | The first meeting of Indian Nursing Council (INC) was held. |
1950: | The INC took decision to establish Auxilliary Nursing and Midwifery (ANM) programme to meet the requirement of workers in nursing. |
1951: | Establishment of urbanfield teaching center is started at College of Nursing, Delhi in collaboration with existing. Municipal Corporation of Hyderabad (MCH) centers of Municipal Corporation, Delhi for teaching of urban community health nursing. |
1952: | |
1953: | Ms Edith Buchanan, vice principal, Rajkumari Amrit Kaur (RAKCON) College of Nursing, New Delhi was sent to Columbia University to earn her Doctorate in Education (DEd) through World Health Organization (WHO) fellowship. |
1954: | Government of India constituted committee to review conditions of services, emoluments; etc. of nursing profession (Shetty committee). Shetty Committee Report was published, recommended nursing staff norms of hospital community and other improvements in nursing. |
1955: | Establishment of child guidance clinic at RAK College of Nursing for providing services and strengthening community health nursing and pediatric nursing. Ms Margareta Craig, principal, College of Nursing, Delhi attended ICN meeting in France, to present a paper on the need for nursing research in India. |
1959: | Dr Edith M Buchanan, succeeded in establishing the long cherished “Master of Nursing” degree programme at RAK College of Nursing, New Delhi under University of Delhi (October 1959). Healthy Survey and Planning Committee (Dr LN Mudaliar) was constituted by Government of India to review the progress made in health since, Bhore committee recommendation. |
1961: | Mudaliar Committee report published made some recommendations to improve nursing profession. |
1963: | A WHO assisted technical project was undertaken at the INC to revise the General Nursing and Midwifery (GNM) course. Dr Buchanan, succeeded in sending Mrs Sulochana Krishnan, one of the first graduates of this newly established, MN degree programme, to earn the DEd degree from Columbia University. |
1964: | Dr Marie Ferguson, a public health nurse came to the College of Nursing, New Delhi was able to create greater appreciation and understanding of the need and value of research in planning nursing administration and education with senior leaders of the country conducted “Activity studies to define the nursing and non-nursing functions of nursing personnel”. |
1965: | A WHO publication on ‘Guide for School of Nursing’ in India was published. |
1966: | Trained Nurse Association of India (TNAI) established research section under the Chairmanship of Ms Margareta Craig. TNAI conducted ‘Time study’ with the co-operation of Ms Anna Gupta, principal, RAKCON, under the supervision of Dr Sulochana Krishnan. |
1969-71: | INAI and VHAI, CHAP conducted study on survey on the socioeconomic status of nurses in India. |
1973: | Kartar Singh Committee report on multipurpose workers and Health and family planning department published and recommended ANM and Lady health visitors (LHVs) were redesignated and health workers (F) and health assistant (F) to cover the required population at rural area for providing proper health services. |
1975: | Srivastav Committee report on 3 tier-plan of health care delivery system to rural area was recommended. |
1976: | Dr Marie Farell and Dr Aparna Bhaduri of RAKCON, New Delhi, conducted seminars on nursing research for educationists at Delhi, Mussoorie (Uttarakhand) and Yarcaid to strength the nursing research in India. |
1978: | Government Nurses Association of Karnataka established. |
1981: | Dr Farrell and Dr Bhaduri‘s book ‘Health Research’—A Community based Approach’ published by World Health Organization. |
1986: | The Nursing Research Society of India (NRSI) was established to promote research within and around nursing environment. Dr (Mrs) Inderjit Walia was founder president. Mrs Uma Handa was its secretary. MPhil in nursing programme started at RAKCON, under Delhi University. |
1987: | |
1988: | RAKCON, New Delhi was designated as World Health Collaboration Centre for Nursing Developments reports of the high power committee on nursing and nursing profession published. Dr Ruth Hurner book “Nursing Education in India” published on the basis of survey. |
1991: | Author registered PhD in nursing at Bangalore University. |
1992: | PhD in nursing programme started at RAKCON, under Delhi University. Mrs Asha Sharma got registered for the Doctoral course. |
1.4 SCOPE OF NURSING
There was a time when professional nurses had very little choice of service because nursing was centered in the hospital and bedside nursing. Career opportunities are more varied now for a numbers of reasons. The list of opportunities available is given under:
- Staff nurse provides direct patient care to one patient or a group of patients. Assists ward management and supervision. She is directly responsible to the ward supervisor.
- Ward sister or Nursing supervisor: She is responsible to the nursing superintendent for the nursing care management of a ward or unit. Takes full charge of the ward. Assigns work to nursing and non-nursing personnel working in the ward. Responsible for safety and comfort of patients in the ward. Provides teaching sessions if it is a teaching hospital.
- Department supervisor/Assistant nursing superintendent: She is responsible to the nursing superintendent and deputy nursing superintendent for the nursing care and management of more than one ward or unit, e.g. surgical department and out-patient department.
- Deputy nursing superintendent: She is responsible to the nursing superintendent and assists in the nursing administration of the hospital.
- Nursing superintendent: She is responsible to the medical superintendent for safe and efficient management of hospital nursing services.
- Director of nursing: She is responsible for both nursing service and nursing educations within a teaching hospital.
- Community Health Nurse (CHN) services rendered mainly focusing Reproductive Child Health programme.
- Teaching in nursing: The functions and responsibilities of the teacher in nursing are planning, teaching and supervising the learning experiences for the students. Positions in nursing education are clinical instructor, tutor, senior tutor, lecturer, and associate professor, Reader in nursing and Professor in nursing.
- Industrial nurses: They are providing first aid, care during illness, health educations about industrial hazards and prevention of accidents.
- Military nurse: Military Nursing service became a part of the Indian Army by which means nurses became commissioned officers who are given rank from lieutenant to major general.
- Nursing service abroad: Attractive salaries and promising professional opportunities, which cause a major increase for nursing service in abroad.
- Nursing service administrative positions: At the state level the Deputy Director of Nursing at the state health directorate. The highest administrative position on a national level is the Nursing Advisor to the Government of India.
CONCLUSION
Nursing is defined as providing care to the healthy or sick individuals for preventive, promotive, curative and rehabilitative needs. The consumers are patients with complex needs. With increased awareness of healthcare, healthcare facilities and Consumer Protection Act, patients/clients are getting awareness about their rights. Nurses also have now the expanded role, with the result the legal responsibility is increased. Hence, it is important for nursing personnel working in hospital, community and educational field to develop understanding of Legal and Ethical issues of Nursing.